Winnipeg, MB - After introducing advanced heart attack therapy in 2008, the Winnipeg Fire Paramedic Service (WFPS) has recently completed STEMI (ST segment Elevation Myocardial Infarction) training with all Primary Care Paramedics (PCP). This enhanced training means that all WFPS PCP’s can now activate the STEMI protocol and provide more timely treatment for patients suffering from the most severe types of heart attacks.
“Patient care is the number one priority in everything that we do,” said Dr. Rob Grierson, Medical Director for the Winnipeg Fire Paramedic Service. “By training our PCP’s to activate the STEMI protocol, we have substantially increased the public’s access to the most timely heart attack care. This additional training will help save lives.”
“The STEMI protocol is an innovative technology that allows patients to get the care they need much more quickly,” said Deputy Chief Tom Wallace, Winnipeg Fire Paramedic Service. “I am proud that the WFPS continues to place a priority on training of its paramedics and firefighter paramedics. I am confident that this enhancement to our PCP’s skillset will mean faster, high-quality care for heart attack victims.”
Since the spring of 2008, WFPS and the WRHA Cardiac Sciences Program have established and maintained a very successful pre-hospital STEMI management protocol. The average treatment time (first medical contact to percutaneous coronary intervention) in Winnipeg for a STEMI event is 70 minutes. This timeline is well under the industry target time of 90 minutes and qualifies as one of the shortest times in the country.
“Expanding the STEMI program to incorporate paramedics has demonstrated a dramatic improvement in the survival rate for people who have suffered heart attacks in Winnipeg,” said Dr. Davinder Jassal, a cardiologist and medical director of the WRHA’s Coronary Care unit. “Prior to our starting this program, the risk of a person dying from a heart attack was one in 10, by 2015, the rate had fallen to one in 30.”
About STEMI (ST segment Elevation Myocardial Infarction)
Paramedics assess a patient who is suffering from chest pain and conduct a 12-lead heart tracing (electrocardiogram or ECG) using a cardiac monitor/defibrillator. Based on this ECG and the patient’s symptoms, paramedics are able to diagnose patients who are having the most severe form of heart attack. This form of heart attack is known as a ST segment Elevation Myocardial Infarction (STEMI).
Once paramedics have identified a patient with a STEMI, they will then transmit a copy of the ECG, via a secure wireless network to an on-call STEMI physician. They will then follow-up that transmission with a call to the STEMI physician to discuss the patient’s case in real time.
Based on this discussion and the ECG, the STEMI physician will recommend one of three possible treatment options:
- Prepare the patient for cardiac catheterization with medication and symptom relief, by-pass the Emergency Department and transport directly to the Cardiac Catheterization Lab (this is the most common treatment option for those with STEMIs);
- Administration of clot-busting medication and transport to the St. Boniface General Hospital Emergency or Coronary Care Unit; or
- If the patient does not have a STEMI, provide ongoing treatment and transport to the closest hospital.
Since the inception in 2008, the program has treated approximately 200 patients each year.
As a result of the WFPS and WRHA partnership, the mortality rate for pre-hospital STEMI patients dropped from 10.4% in 2007 to 3.5% in 2015.
The WFPS currently has 533 PCP’s on staff (365 firefighter PCP’s and 168 ambulance-based PCP’s).